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Dr. Larissa Rodríguez

Dr. Larissa Rodríguez: Breaking down barriers to care for women with pelvic floor disorders

Dr. Larissa Rodríguez

Although she is one of only eight female urology chairs in the country, Larissa Rodríguez, M.D., urologist-in-chief at NewYork-Presbyterian and Weill Cornell Medicine and chair of the Department of Urology at Weill Cornell Medicine, sees this as an opportunity rather than a challenge: As a specialist in female pelvic health, her work shines a light on just how comprehensive the field is.

“When most people think of urology, they just think of prostate cancer,” says Dr. Rodríguez. “In reality, you can treat men, women, and children. During my residency I realized that the need in women’s urological health was tremendous, and that there was so much we didn’t know about why some women have the issues they do. I wanted to be at the forefront of research and care for women in this field.”

Today, Dr. Rodríguez is a leader in both treating and researching pelvic floor disorders (PFD) and in advocating for improved access to care for all women. She spoke to NYP Advances to discuss her research to understand both the biological and social factors that impact PFDs, and what she believes physicians need to do to change the narrative around these common, yet highly treatable, conditions.  

How did you feel as a female trainee entering a male-dominated field? 

It never deterred me. It was never a concern for me because I like to break barriers. So even though urology was also male-dominated, I ultimately chose it because you are treating patients for both life-threatening conditions as well as quality-of-life issues that can be lifelong, and you develop long-term relationships with them, which is unusual in a surgical field.

In residency, most of my patients were male, but I found they were very receptive to women doctors; it was almost as if they could be more vulnerable with us. So, I believe any barriers to women entering the field are more professional than due to patient sentiment. Currently about 11.8% of urologists are women, but when I joined residency, it was less than 2%. The field is slowly changing, but we still need to make progress, and it’s gratifying to be in a position where I can push change forward. This year, three out of the four urology residents we accepted are women, which is tremendous. 

“Latinas seek care for their pelvic floor disorder symptoms much later than other racial or ethnic groups, resulting in a delay in diagnosis. One of my areas of focus is trying to understand the cultural factors that influence this.”

— Dr. Larissa Rodríguez

About a quarter of women will be affected by a pelvic floor disorder (PFD), but many go years without a proper diagnosis. What do you believe contributes to this?

A significant barrier is the knowledge gap among healthcare providers. Conditions like urinary or fecal incontinence and interstitial cystitis/bladder pain syndrome (IC/BPS) can be debilitating, yet they are often dismissed as normal aspects of aging when they are anything but normal. Many women go from doctor to doctor without getting a proper diagnosis, or they are misdiagnosed with urinary tract infections and given antibiotics, then get stuck with this diagnosis for years. A lot of my patients with bladder pain are self-referrals because they don’t get the answers they need and find me through their own research or online communities.

The other half of this is the social stigma around PFDs. I often hear stories from my older patients about how, for instance, they don’t visit their grandchildren because they’re afraid of wetting the bed while being a guest. I think it’s sad that this stigma continues to persist, and with more frequency among certain groups and those with socioeconomic disparities. We know, for instance, that Latinas seek care for their PFD symptoms much later than other racial or ethnic groups, resulting in a delay in diagnosis that affects the outcomes of their treatments. One of my areas of focus is trying to understand the cultural factors that influence this as well because there has been little research done on the Latina population.

Can you discuss some of the findings of your research on Latina women?

My colleagues and I recently published research that looks at self-reported data from community-dwelling Latinas to understand if cultural and psychosocial factors influence whether they can identify that they have a PFD. There was a stark disconnect between their symptoms and self-identification: 63% of women reported having at least one PFD symptom — and 39% had moderate to severe symptoms — but only 15% believed they had a PFD.

Our analysis showed that women were more likely to self-identify if they were older, had more bothersome symptoms, or were more assimilated to American culture. Conversely, women were more likely to be unsure of having a PFD if they placed a lower value on independence, placed a higher value on religion, or had higher perceived stress. While more research needs to be done to understand cultural barriers to care, we can use this type of data to develop community interventions that educate and empower women to recognize when they need care and how to seek it. 
 

“Understanding the communication between the brain and the bladder is the next frontier in research for our field and can help us explore new treatments.”

— Dr. Larissa Rodríguez

Stress seems to be a key environmental factor that impacts pelvic and bladder health. What has your lab uncovered around this?

We know that stressful situations and mental health issues such as depression and anxiety are associated with the development of bladder pain, urinary frequency, and incontinence. To better understand this dynamic, in my lab we are conducting basic science research using an animal model in which the animals are exposed to a very mild stressor. They end up developing pretty much all the symptoms of patients with IC/BPS: pain in the bladder, urinary frequency, and urgency. I think understanding the communication between the brain and the bladder is the next frontier in research for our field and can help us explore new treatments that are geared toward how the brain or nervous system modulates urinary function. I have a few Ph.D.’s with a background in neuroscience in my lab that I collaborate with closely on this research.

What do you think the medical community needs to do to improve the underdiagnosis of PFDs? 

I think there are a lot of missed opportunities to screen for pelvic floor disorders during standard examinations. Women get pap smears and vaginal exams every year — why not use that chance to test for incontinence or prolapse, or ask patients about sexual function and other things related to pelvic floor health so they can be referred to the right specialists? This would be beneficial on the primary care side, too. Unfortunately, doctors don’t always have enough knowledge of pelvic floor conditions to even ask about it, so there needs to be more education. They are also busy assessing potentially life-threatening conditions such as diabetes, high blood pressure, and weight, and sometimes do not have the time during a routine visit to prioritize and ask about other quality-of-life issues.

You’ve been vocal about the fact that treating pelvic disorders requires a multidisciplinary approach. How have you put that into practice?

We established the Center for Female Pelvic Health at NewYork-Presbyterian and Weill Cornell Medicine, which combines multidisciplinary expertise to treat pelvic floor conditions as well as conducts clinical trials and research. We bring together experts in urology, gynecology, gastroenterology, and physical therapy to provide comprehensive care and explore both surgical and nonsurgical treatment options. Providing physical therapy as a part of a treatment plan, for example, is especially rare. There are many surgeons who go straight to surgical repair when in reality many conditions can get better through strengthening the pelvic floor muscles. Taking a collaborative approach helps us provide better personalized treatment.

I’m also the director of a fellowship that, for the past three years, has been training gynecologists and urologists in pelvic floor conditions. We take applicants for both specialties and train them together so that we can develop a new generation of physicians who have a deeper knowledge of how to treat these disorders. Through these efforts, our goal is to build a new standard of care.

Learn More

Rude T, Sevilla C, Chen N, Marin P, Chavez A, Yosufi N, Unger JB, Baezconde-Garbanati L, Dancz CE, Ginsburg D, Rodríguez LV, Stern MC. Self-identification of Pelvic Floor Disorder Symptoms Among Latina Women: The Roles of Knowledge, Attitude, Behaviors, Beliefs, and Psychosocial Factors. Journal of Racial and Ethnic Health Disparities. Published online June 17, 2025. doi:10.1007/s40615-025-02421-w

Sandberg ML, Santurri L, Klumpp D, Rodríguez LV, Clauw D, Lai H. A Review of the Etiopathology of Phenotypes in Interstitial Cystitis/Bladder Pain Syndrome. Neurourology and Urodynamics. Published online June 29, 2025. doi.org/10.1002/nau.70097

Johnson EV, Bachmann M, Yani MS, Eckel SP, Garcia GI, Rodríguez LV, Kitch JJ. Reducing pain by improving brain and muscle activity with motor cortical neuromodulation in women with interstitial cystitis/bladder pain syndrome: a study protocol for a randomized controlled trial. Trials. 2024;25(1). doi.org/10.1186/s13063-024-08450-w

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Dr. Larissa Rodriguez
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